Cedarwood House Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. The manager carried out pre-assessment checks for people wanting to live at the home or people having been placed at the home by the local authority. In most cases these assessments were carried out face to face and involved the person’s relatives or advocates. Information was sought from other professionals where appropriate for example, hospital staff, social workers and GPs. After moving in, people’s settling in, and progress was closely monitored with a review at 2 weeks followed by regular checks with family members to make sure people were safe and had settled into the home. Relatives told us they were part of this process but varied in their recollection of being involved in any ongoing reviews of people’s support needs. However, they all told us the communication from the service had improved significantly over the past 12 months and that they were kept informed of any changes in their loved ones.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. People and relatives told us that health and social care appointments were made according to people’s needs. These included GP appointments or visits from the podiatrist or occupational health. People’s health was monitored and where there were concerns, recognised tools were used, for example the Malnutrition Universal Screening Tool (MUST) for measuring people’s likelihood of developing malnutrition. Similarly, Waterlow scores were used. This was a process of assessing people’s likelihood of developing pressure sores. A weekly GP round at the home meant that people were seen and assessed regularly and any changes to people’s health or presentation could be identified and addressed as required.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. The manager had established a positive working relationship with professionals that visited or advised the service from both health and social care. This joined up approach led to people getting prompt and relevant support from specialists when needed. A relative told us that their loved one had recently developed issues with swallowing their food. They told us, “They called in the SALT team straight away and they made some recommendations and the GP visits every Friday which is good to know.” SALT are the speech and language therapist team who specialise in supporting people experiencing difficulties with eating and drinking. Professionals also told us of the relationship with the home and that they knew that people were supported to get the help they needed. A professionals told us, “I have a good working relationship with the current Manager and the Senior Care team.” Another added, “I was given the contact details for the new manager so I reached out to them and I suggested we had a meeting which was productive.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. People’s nutrition and hydration needs were met. The kitchen was well equipped and was run by an experienced chef who knew people well. The chef and their team were aware of people’s likes, dislikes, allergies and food preferences. Details of people needing a diabetic based diet were known and details were clearly marked on a board in the kitchen. Cleaning schedules, including a weekly deep clean, were documented along with daily temperature checks of food and equipment. A four weekly, seasonal menu was in place and people chose alternative meals if they wanted. At breakfast we saw people come to the dining room sporadically over a 2-hour period and each was approached by the chef and asked what they would like. Options were described and people given time to make their choice. Meals were then freshly prepared. People told us the food and service were good. A relative said, “Food is very good, excellent. They have several chefs and do well with the meals.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. Some areas of people’s ongoing health and support needs were monitored for example, weights and likelihood of developing skin pressure damage. Other areas for example, oral health were not so closely monitored. Risk assessments were in place for oral health, but it was unclear if they had been recently updated. One risk assessment stated a person had poor gum health with occasional bleeding and stated that the person rarely let staff support them. A best interest meeting concluded that it was not required to take the person to the dentist as any treatment would be refused. It remained unclear how the person’s oral health was to be safely managed. On the front of each electronic care plan there was a timeline of daily events and activities that were electronically signed and timed. Several entries across different care plans for oral health and brushing of teeth were left blank, with no explanation.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Care plans described people’s health conditions that may affect their ability to make certain decisions. Staff were aware that people living with dementia’s ability to make some decisions was deteriorating and that there was a need for regular reviews. The manager had put a process in place but this needed time to fully embed. Staff knew people well and knew about the importance of gaining consent from people before carrying out personal care or other daily tasks where support were needed. A relative told us, “They do know mum’s reactions and sometimes she just doesn’t want to get up. Her liberty and her decisions are respected.”